title: Clinical experience with daptomycin in Europe: the first 2.5 years.
abstract: OBJECTIVE
  To describe the patient populations and infections being treated with daptomycin, as well as the efficacy and safety outcomes.
  
  
  METHODS
  Data from the European Cubicin Outcomes Registry and Experience (EU-CORESM), retrospectively collected at 118 institutions between January 2006 and August 2008, were analysed.
  
  
  RESULTS
  Daptomycin treatment was documented in 1127 patients with diverse infections, including complicated skin and soft tissue infections (33%), bacteraemia (22%), endocarditis (12%) and osteomyelitis (6%). It was used empirically, before microbiological results became available, in 53% of patients. Staphylococcus aureus was the most common pathogen (34%), with 52% of isolates resistant to methicillin; coagulase-negative staphylococci and enterococci were also frequent, with 22% of Enterococcus faecium isolates resistant to vancomycin. Daptomycin was used as first-line therapy in 302 (27%) patients. When used second line, the most common reasons for discontinuation of previous antibiotic were treatment failure and toxicity or intolerance. The use of concomitant antibiotics was reported in 65% of patients. Most frequent doses were 6 mg/kg (47%) and 4 mg/kg (32%). The median duration of daptomycin therapy was 10 days (range 1-246 days) in the inpatient setting and 13 days (range 2-189 days) in the outpatient setting. The overall clinical success rate was 79%, with a clinical failure rate of <10% for all infection types. Low failure rates were observed in first- and second-line therapy (6% and 8%, respectively). Daptomycin demonstrated a favourable safety and tolerability profile regardless of treatment duration.
  
  
  CONCLUSIONS
  Daptomycin has a relevant role in the treatment of Gram-positive infections.
authors.affiliation: Microbiology Department, Darent Valley Hospital, Dartford and Gravesham NHS Trust, Dartford, UK. armando.gonzalez@dvh.nhs.uk
authors.forename: Armando
authors.initials: A
authors.lastname: Gonzalez-Ruiz
authors.forename: Andres
authors.initials: A
authors.lastname: Beiras-Fernandez
authors.forename: Hans
authors.initials: H
authors.lastname: Lehmkuhl
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Seaton
authors.forename: Juergen
authors.initials: J
authors.lastname: Loeffler
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Chaves
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D017576:Daptomycin / Q000009:adverse effects / Q000627:therapeutic use*; D016984:Enterococcus faecium / Q000187:drug effects / Q000302:isolation & purification; D005060:Europe; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013210:Staphylococcus / Q000187:drug effects / Q000302:isolation & purification; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin